Photo Credit: Paul Biris

The following is a summary of “Diagnostic value of T-tube cholangiography and choledochoscopy in residual calculi after biliary surgery,” published in the October 2024 issue of Gastroenterology by Li et al.

Residual bile duct stones post-surgery pose diagnostic challenges, and techniques like T-tube cholangiography and choledochoscopy are commonly used for their detection. For a study, a team of researchers aimed to assess the diagnostic accuracy of these methods in detecting stones left after biliary surgery and to explore the efficacy of routine T-tube cholangiography before removal.

With this retrospective study, they reviewed the clinical records of 287 adults treated at Xuanwu Hospital, Capital Medical University, between 2017 and 2022, who underwent common bile duct exploration, T-tube drainage, followed by cholangiography and choledochoscopy six to eight weeks post-surgery. Patients with bile duct tumors, incomplete records, or contraindications were excluded. Statistical tests, including the McNemar and Kappa tests, were used to analyze the consistency between T-tube cholangiography and choledochoscopy results.

Of the 287 patients, T-tube cholangiography detected residual stones in 38 cases, of which choledochoscopy confirmed 29. Among patients with no residual stones detected by T-tube cholangiography, choledochoscopy later identified retained stones in 11 cases. Despite these discrepancies, the overall agreement between the two methods was high, with no significant difference (P = 0.82) and a Kappa value of 0.70 (95% CI, 0.65–0.76).

The study concluded that T-tube cholangiography and choledochoscopy provide similar diagnostic accuracy for detecting residual bile duct stones after surgery. The choice of diagnostic approach should be tailored to each patient’s clinical condition to optimize postoperative care.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03474-7